From the March 2011 issue of HealthCare Business News magazine
Getting from A to B (traditional transcription supported clinical documentation to clinicians using an EMR system with no other support) is not easy. Above the line of disruption, shown at point A, there is no change required in physician behavior, below the line, shown at point B, physicians must adapt to new solutions and change their working practices. While there are benefits to these changes, the additional effort and skills required of busy clinicians can be overwhelming. EMR workflow also tends to interrupt the diagnostic process by requiring the clinician to focus on the system (the keyboard, screen and mouse) rather than focusing on the patient. This can lead to patient and clinician dissatisfaction.
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There are many reasons health care organizations should consider speech recognition, particularly if they are looking for ways to ease the burden of an EMR implementation. Speech recognition relieves physicians of the need to point and click through structured EMR templates to convey a complicated patient narrative. With EMRs, it has really transitioned to being a fundamental enabler to the system.
The first step toward achieving physician buy-in is to understand your choices and their associated pros and cons. There are two types of speech-recognition technology:
• Backend: A physician dictates into a digital dictation system that records an audio file. The file is then converted to a centralized system where it is recognized and subsequently edited by a transcriptionist.
• Frontend: A physician dictates into a speech-recognition engine in which words are recognized and displayed immediately after they are spoken. The dictator is responsible for editing and signing off on the document.
As shown in figure 1, the challenge of clinical documentation can be addressed by marrying tailored technologies with clinicians’ preferred workflows. At this day and age, it is unreasonable to have clinicians fully reliant on medical transcriptionists who perform in the traditional way (typing documents from scratch); the simple reason being cost and non-compliance with EMRs.
